A perspective on children's health in Glasgow

07 December 2016

Bruce Whyte discusses a new set of children and young people's health and wellbeing profiles, which aim to help inform services planning and identify population health patterns.

In this age of social media and web news, it often feels like we have lots of data – sometimes maybe too much. However, despite this, in the field of public health we still lack accessible and up to date population health information for local communities.

The profiles published in early December are the product of 2 years of joint multi-disciplinary thinking and planning that once started took 7 months to complete. The work was overseen by a multi-agency advisory group and their construction was undertaken by analysts from ISD Scotland (see acknowledgements below).

The profiles comprise a broad range of indicators across different domains that we know are important for children and young people's health, wellbeing and quality of life throughout their lives. They cover 56 Glasgow neighbourhoods, 3 localities (North West, North East and South Glasgow) and Glasgow as a whole. All the indicators are based on aggregated data. No disclosive or identifiable data are shown.

The aim of these profiles is to:

Provide organisations and communities with up-to-date and locally relevant public health intelligence relating to children, their health and their life circumstances across the city;

Show trends in key indicators;

Highlight health and socioeconomic inequalities;

Provide local level information for targeting resources and priority setting.

Who are they for? How might they be used?

The profiles aim to inform children's services planning and delivery in Glasgow including planning and evaluation of new models of family support and early learning and child care in the city. Information provided can also help local community and third sector organisations obtain a picture of key population health patterns, trends and issues in their local area which they can draw on for a range of purposes. In addition, the profiles can be utilised in educational settings such as in secondary school modern studies curriculum, college/university courses etc.

Reflecting on the data

Having discussed, specified and checked most of the indicators included in the profiles I have a few reflections on what they show:

Glasgow's neighbourhoods really are very different and children's life circumstances vary dramatically across the city. The variations in child poverty, lone parent households and healthy life expectancy across the city illustrate this well.

One indicator that stands out is healthy life expectancy. It is worth remembering that this is an estimated statistical measure, based on historical mortality rates (in part) and has relatively wide confidence levels - representing the uncertainty in the estimate. That said, the healthy life expectancy measure is striking not least because it suggests that in some communities men and women live on average slightly less than 50 years in good health, while in other areas people can live for 70 years in good health on average. This represents a wide inequality gap and one that is even more pronounced than for overall life expectancy.

We have developed an indicator of children’s access to green space. The measure we use is a proxy for this which measures the number and proportion of children living in proximity (400m) to publicly accessible green space. However the current indicator takes no account of the quality, condition or level of safety of that green space. We are working to get a better measure that does take this into account. Behind this indicator is a recognition that providing access to natural outdoor environments is important for child development, learning and for physical and mental health.

Indicators of child development such as the indicator of likely development difficulties among children in their pre-school year and communication delay for young children (at 30 months) have been included, but we will have to be careful in how we interpret these relatively new indicators which may not be as reliable as we hope or be recorded consistently across the city.

The measure used to indicate a young baby's exposure to environmental smoke might better be described as ‘babies potentially exposed to passive smoking’. This will be replaced later next year with a more direct measure of exposure to second hand smoke.

The education indicator which records ‘school leavers going onto positive destinations’ (e.g. higher or further education ,employment or training) is a useful overall indicator of post-school destination but is less helpful in differentiating pupils’ levels of educational attainment and future opportunities. The S4 attainment indicator illustrates the gap in attainment much more clearly.

Evidence into action

The evidence for action briefings which accompany the profiles are a new addition to profiling in Scotland. They have been added as a way of linking the data in the profiles closely with the evidence base for action.

For example, if child poverty is a pressing issue; what steps can be taken to mitigate the worst consequences of this? If we want more children to walk or cycle or skate to school; how can we enable this to happen and what needs to be in place?

There are currently briefings on nine topics. We expect these to be relevant to people working across a range of settings (health, social services, education, housing, planning, culture, leisure and the third sector) who are planning or providing services. If the briefings are seen as helpful we will look to provide more.

Let us know what you think

We would welcome feedback on the profiles, and on the evidence for action briefings. We are particularly interested in knowing how the profiles are being used as this can inform how we design future resources. Email your feedback to us.

We would also like to acknowledge the team who produced the evidence for action briefings: Jane White, Eileen Scott (NHS Health Scotland), Lynn Naven, James Egan, Fiona Crawford and Bruce Whyte (GCPH).

About the author

Bruce Whyte
Public Health Programme Manager

Bruce co-leads the Centre’s ‘Observatory Function’ and is responsible for developing and managing a comprehensive public health information programme. His current work includes the Glasgow Indicators Project, creating new children’s health profiles and exploring health trends in Glasgow’s neighbourhoods. He also leads GCPH's on-going programme of research into active travel.

He has previously undertaken a comparison of Scotland’s mortality profile within Europe and managed a programme of research into breastfeeding in a Scottish context. Bruce jointly coordinates the national PHINS (Public Health Information Network for Scotland). He is an Honorary Senior Lecturer at the University of Glasgow.